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Harvey AA, Morjaria P, Tousignant B. Priorities in school eye health in low and middle-income countries a scoping review. Eye (Lond) 2024; 38:1988-2002. [PMID: 38565599 PMCID: PMC11269736 DOI: 10.1038/s41433-024-03032-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 02/02/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
School eye health (SEH) has been on the global agenda for many years, and there is mounting evidence available to support that school-based visual screenings are one of the most effective and cost-efficient interventions to reach children over five years old. A scoping review was conducted in MEDLINE, Web of Science, PubMed, and CINHAL between February and June 2023 to identify current priorities in recent literature on school eye health in low- and middle-income countries (LMICs). Selection of relevant publications was performed with Covidence, and the main findings were classified according to the WHO Health Promoting Schools framework (HPS). A total of 95 articles were included: cross-sectional studies (n = 55), randomised controlled trials (n = 7), qualitative research (n = 7) and others. Results demonstrate that multi-level action is required to implement sustainable and integrated school eye health programmes in low and middle-income countries. The main priorities identified in this review are: standardised and rigorous protocols; cost-effective workforce; provision of suitable spectacles; compliance to spectacle wear; efficient health promotion interventions; parents and community engagement; integration of programmes in school health; inter-sectoral, government-owned programmes with long-term financing schemes. Even though many challenges remain, the continuous production of quality data such as the ones presented in this review will help governments and other stakeholders to build evidence-based, comprehensive, integrated, and context-adapted programmes and deliver quality eye care services to children all over the world.
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Affiliation(s)
- Alex-Anne Harvey
- Department of Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC, Canada
| | - Priya Morjaria
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- Peek Vision, Berkhamsted, UK
| | - Benoit Tousignant
- Department of Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC, Canada.
- School of Optometry, Université de Montréal, Montreal, QC, Canada.
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Morgan OA, Mirza AA, Parmar KR, Plowright AJ, Vega JA, Orsborn GN, Maldonado-Codina C, Whitehead JC, Morgan PB. Clinical performance and Willingness To Pay for soft toric contact lenses in low and moderate astigmats. Cont Lens Anterior Eye 2023; 46:101887. [PMID: 37460374 DOI: 10.1016/j.clae.2023.101887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/11/2023] [Accepted: 06/28/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE To determine clinical performance and the 'Willingness To Pay' for toric vs. spherical soft contact lenses in an astigmatic population. METHODS In the clinical study, subjects with binocular low to moderate astigmatism (-0.75DC to -1.50DC) wore pairs of soft toric (Biofinity toric) and spherical (Biofinity) contact lenses in random sequence. Visual acuity (high and low contrast, monocular and binocular), subjective comfort and subjective vision were recorded. In the economics study, first subjects who had participated in the clinical study were presented with a series of randomised economic scenarios in order to determine their Willingness To Pay a premium (i.e. an increase) for toric lenses. Then, a similar set of scenarios were presented to a much larger group of online respondents and again, Willingness To Pay was established. RESULTS For the four measures of visual acuity, the Biofinity toric lens out-performed the Biofinity spherical lens by 0.6 to 1.1 lines.. Subjective vision performance was statistically significantly better with the toric lens for the distance task only. Comfort scores were not significantly different. Similar findings for Willingness To Pay were established for the clinical subjects and for the online respondents. The Willingness To Pay premium (additional fee) for a monthly supply of toric lenses (over spherical lenses) was between £13 and £16, if a toric lens provides better vision and similar comfort, as shown in the clinical study. CONCLUSION Consumers are willing to pay a monthly premium of around 50% to benefit from the typical experience of better vision and similar comfort for toric vs. spherical lenses. The level of additional cost for toric lenses compared to their spherical equivalents is less than this in the market, so eye care professionals should consider that toric lenses are delivering a greater clinical return than anticipated by wearers for the relatively small increase in price.
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Affiliation(s)
- O Ashton Morgan
- Department of Economics, Appalachian State University, Boone, NC 28608, United States
| | - Aftab A Mirza
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom
| | - Ketan R Parmar
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom
| | - Andrew J Plowright
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom
| | - Jose A Vega
- CooperVision Incorporated, 6101 Bollinger Canyon Rd, Suite 500, San Ramon, CA 94583, United States
| | - Gary N Orsborn
- CooperVision Incorporated, 6101 Bollinger Canyon Rd, Suite 500, San Ramon, CA 94583, United States
| | - Carole Maldonado-Codina
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom
| | - John C Whitehead
- Department of Economics, Appalachian State University, Boone, NC 28608, United States
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom.
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Ebri AE, O'Neill C, Azubuike K, Congdon N, Graham C, Lohfeld L, Chan VF. Caretakers' stated willingness to pay for children's spectacles in cross river state, Nigeria and its implication for a cross-subsidisation scheme: a cross-sectional study. BMC Public Health 2023; 23:1075. [PMID: 37277747 DOI: 10.1186/s12889-023-15901-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 05/16/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Understanding caretakers' willingness to pay (WTP) for their children's spectacles is essential to improving the sustainability of refractive error services and spectacle provision. Therefore, we investigated the willingness of caretakers to pay for their children's spectacles in a multi-centre study to develop a spectacle cross-subsidisation scheme in the Cross River State (CRS), Nigeria. METHODS We administered the questionnaire to all caretakers whose children were referred from school vision screenings to four eye centres for full refraction assessment and dispensing of corrective spectacles from 9 August to 31 October 2019. We collected information on socio-demography, children's refractive error types, and spectacle prescription and then asked the caretakers about their WTP for the spectacles using a structured questionnaire and bidding format (in the local currency, Naira, ₦). RESULTS A total of 137 respondents (response rate = 100%) from four centres were interviewed: with greater proportion of women (n = 92, 67.1%), aged between 41 and 50 years (n = 59, 43.1%), government employees (n = 64, 46.7%) and had acquired college or university education (n = 77, 56.2%). Of the 137 spectacles dispensed to their children, 74 (54.0%) had myopia or myopic astigmatism (equal to or greater than 0.50D). The mean stated WTP for the sample population was ₦3,560 (US$ 8.9) (SD ± ₦1,913.4). Men (p = 0.039), those with higher education (p < 0.001), higher monthly incomes (p = 0.042), and government employees (p = 0.001) were more willing to pay ₦3,600 (US$9.0) or more. CONCLUSION Combining our previous findings from marketing analysis, these findings provided a basis to plan for a children's spectacles cross-subsidisation scheme in CRS. Further research will be needed to determine the acceptability of the scheme and the actual WTP.
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Affiliation(s)
| | - Ciaran O'Neill
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Institute of Clinical Science, Queen's University Belfast, Block A, Royal Victoria Hospital, BT12 6BA, Northern Ireland, UK
| | | | - Nathan Congdon
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Institute of Clinical Science, Queen's University Belfast, Block A, Royal Victoria Hospital, BT12 6BA, Northern Ireland, UK
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
| | - Christine Graham
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Institute of Clinical Science, Queen's University Belfast, Block A, Royal Victoria Hospital, BT12 6BA, Northern Ireland, UK
| | - Lynne Lohfeld
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Institute of Clinical Science, Queen's University Belfast, Block A, Royal Victoria Hospital, BT12 6BA, Northern Ireland, UK
| | - Ving Fai Chan
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Institute of Clinical Science, Queen's University Belfast, Block A, Royal Victoria Hospital, BT12 6BA, Northern Ireland, UK.
- College of Health Sciences, University KwaZulu Natal, Durban, South Africa.
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Yong AC, Chuluunkhuu C, Chan VF, Stephan T, Congdon N, O’Neill C. A pilot cost-benefit analysis of a children’s spectacle reimbursement scheme: Evidence for Including children’s spectacles in Mongolia’s Social Health Insurance. PLoS One 2022; 17:e0273032. [PMID: 35969626 PMCID: PMC9377584 DOI: 10.1371/journal.pone.0273032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background and aim Globally, 12.8 million children have vision impairment due to uncorrected refractive error (URE). In Mongolia, one in five children needs but do not have access to spectacles. This pilot cost-benefit analysis aims to estimate the net benefits of a children’s spectacles reimbursement scheme in Mongolia. Methods A willingness-to-pay (WTP) survey using the contingent valuation method was administered to rural and urban Mongolia respondents. The survey assessed WTP in additional annual taxes for any child with refractive error to be provided government-subsidised spectacles. Net benefits were then calculated based on mean WTP (i.e. benefit) and cost of spectacles. Results The survey recruited 50 respondents (mean age 40.2 ± 9.86 years; 78.0% women; 100% response rate) from rural and urban Mongolia. Mean WTP was US$24.00 ± 5.15 (95% CI US$22.55 to 25.35). The average cost of a pair of spectacles in Mongolia is US$15.00. Subtracting the average cost of spectacles from mean WTP yielded a mean positive net benefit of US$9.00. Conclusion A spectacle reimbursement scheme is potentially a cost-effective intervention to address childhood vision impairment due to URE in Mongolia. These preliminary findings support the proposal of the inclusion of children’s spectacles into existing Social Health Insurance. A much larger random sample could be employed in future research to increase the precision and generalisability of findings.
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Affiliation(s)
- Ai Chee Yong
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | | | - Ving Fai Chan
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
- College of Health Sciences, University KwaZulu Natal, Durban, South Africa
- * E-mail:
| | - Tai Stephan
- Orbis International, New York City, New York, United States of America
| | - Nathan Congdon
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
- Orbis International, New York City, New York, United States of America
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
| | - Ciaran O’Neill
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
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